There is increasing recognition of the emotional and psychological needs of acquired brain injury survivors, and for psychotherapeutic interventions which support such needs, to be integrated in brain injury rehabilitation. This paper focuses on the issue of self-concept following brain injury specifically. Existing literature regarding the impact of acquired brain injury on self-concept is reviewed, with a particular focus on adult populations who have experienced both traumatic and non-traumatic acquired brain injury. Conditions specific to the experience of acquired brain injury which can give rise to changes in individuals’ sense of self are identified, and the development of revised self-concepts stimulated by the injury experience is acknowledged also. The practical application of narrative therapy to support ABI survivors’ development of self-concept post-injury is presented. Externalising and re-authoring practices, and the use of outsider witnesses are described, and the relevance of such methods of narrative therapy in work with ABI survivors specifically is proposed. This paper concludes that narrative therapy’s focus on facilitating people to revise problem-saturated self-narratives and to develop preferred ones, has particular merit in supporting ABI survivors to establish improved understandings of themselves and more positive self-images following brain injury.